| NPI | 1649540121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CHAD OWENS Physician 580-234-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK APA2056) |
| Enumeration Date | 2011-12-30 |
| Last Update Date | 2011-12-30 |